Objective Recent studies have demonstrated gender differences in functional outcome after stroke. However, the underlying reasons for differences have been inconsistent. The present study examined whether gender differences in long-term functional outcomes exist among surviving patients with first-ever ischemic stroke and with individual subtypes of stroke. Methods A total of 997 patients (654 men, 343 women) were followed for 5 years after discharge. Patients were assigned to 4 subtypes of ischemic stroke (atherothrombotic, lacunar, cardioembolic and unclassified infarction). Functional outcomes were expressed as locomotor activity, assessed using a questionnaire delivered by mail 1 and 5 years after stroke. Locomotor function was classified into 5 categories according to the grade of disability. Results Women showed significantly worse locomotor function than men at both 1 and 5 years (p < 0.001 and p < 0.01, respectively). Furthermore, significant gender differences in functional outcome were observed in all subtypes of ischemic stroke at 1 and 5 years after stroke. Logistic regression analysis revealed that gender was a significant determinant for functional outcome at 1 and 5 years after stroke (p < 0.01 and p < 0.001, respectively). No significant gender difference was seen in the rate of stroke recurrence. Women also showed a worse survival ratio after stroke than men (p < 0.01). Conclusion The present study demonstrated significantly worse functional outcomes for women than for men at 1 and 5 years after stroke. Gender differences in long-term functional outcomes by subtypes of ischemic stroke were also significant.

[Purpose] The aim of this study was to determine the reference values for the chair stand test (CST) in healthy older Japanese people. [Methods] Relevant research articles for the 5-repetition chair stand test (CS-5) and the 30-second chair stand test (CS-30) were identified by electronic database and manual searching. Research articles involving healthy Japanese people aged 60 years and older were included in a meta-analysis. Weighted means of the CS-5 and CS-30 were estimated by the random effect model as the reference values for the CST. Further, the effects of age and sex on the reference values were analyzed by a meta-regression analysis. [Results] Seven articles (21 data) and three articles (14 data) were included in the meta-analyses for the CS-5 and CS-30, respectively. The reference value for the CS-5 was estimated as 8.50 sec [95% confidence interval (CI): 7.93-9.07]; age and sex were not associated with this reference value. The reference value for the CS-30 was estimated as 17.26 times [95%CI: 15.98-18.55], and age was significantly associated with this value. [Conclusion] When the CS-5 and CS-30 are used to evaluate elderly Japanese people, the reference values for the CS-5 and CS-30 determined in this study would be useful indices.

The aim of the present study was to investigate the effects of home-based exercise without home visits on physical function, falls, and bone mineral density in community-dwelling elderly women. Sixty community-dwelling, elderly (≥65 years of age) women were recruited from a Japanese community. Subjects were randomly assigned to a home-based exercise group or a control group. The subjects assigned to the home-based exercise group performed home-based exercise without home visits 3 times per week for 6 months in their homes. Assessments of physical function and bone mineral density were carried out before and after intervention in both groups. Muscle strength, gait velocity, the timed up and go test (TUGT), single leg stance time, the bend reach performance test, and reaction time were measured to assess physical function. The patients' history of falls was also assessed before and after the 12-month follow-up. To determine bone mineral density, the speed of sound (SOS) at the right calcaneus was measured using a quantitative ultrasound device. There were no significant differences between the two groups in baseline characteristics. 82.6% of subjects completed the prescribed exercise program in the home-based exercise group. Compared to the control group, TUGT improved significantly (p<0.05) in the home-based exercise group. Home-based exercise without home visits can be adopted for community-dwelling elderly women, particularly since no specific place or instructor is needed.

[Purpose] Maintaining high quality of life is crucial for the rehabilitation of patients with Parkinson's disease. The quality of life scales currently in use do not assess all quality of life domains or their importance for each individual. Therefore, a new quality of life measure, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, was used to investigate quality of life in people with Parkinson's disease. [Subjects and Methods] Fifteen people with idiopathic Parkinson's disaese (average age = 80.0 years, standard deviation = 10.3 years, Hoehn & Yahr stages 1-4) were interviewed using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting. Its quality of life constructs were tested by comparing them against disease-specific quality of life (39-items Parkinson's Disease Questionnaire), motor functioning (Unified Parkinson's Disease Rating Scale Part III), and activities of daily living (Barthel Index). [Results] Social connections such as "family" and "friends" were revealed as important constructs of life satisfaction. The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting was not significantly correlated with the 39-items Parkinson's Disease Questionnaire, Unified Parkinson's Disease Rating Scale Part III, or Barthel Index but was significantly correlated with the "communication" dimension of the 39-items Parkinson's Disease Questionnaire. [Conclusion] The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting detected various domains of quality of life, especially social relationships with family and friends. "Being heard" was also revealed as an essential component of life satisfaction, as it provides patients with a feeling of acceptance and assurance, possibly resulting in better quality of life.

Objectives Reference values for hand grip strength in Japanese community-dwelling elderly independent in activities of daily living (ADLs) were calculated by meta-analysis. Methods Papers reporting data on hand grip strength in elderly Japanese adults ≥60 years of age and independent in ADLs were retrieved from electronic databases. Data were extracted from the selected papers and the weighted mean for hand grip strength by sex was calculated by random effect model. The association of hand grip strength with age and body weight was also analyzed using meta-regression analysis. Results Data for 15,784 individuals (5216 men and 10,568 women; mean age 67.0–79.8 years) were extracted from 97 sets of data from 33 papers. The weighted mean for hand grip strength was calculated as 33.11 kg [95 % CI 32.27–33.96] in men and 20.92 kg [95 % CI 20.45–21.39] in women. A significant negative correlation was also seen between hand grip strength and age. Conclusions The mean hand grip strength of elderly people calculated in this study can be used as a reference value for the hand grip strength of Japanese community-dwelling elderly who are independent in ADLs. However, age needs to be considered in reference values for hand grip strength.